Q: Dear GQ Doc, I read with increasing frequency that obesity is putting strain on the NHS. What’s the truth in this? Alex, via email

A: It’s no secret that the NHS is in £750 million deficit crisis. And while the politicians, health tsars and media dissect rational (and some desperate) methods to ease the unsustainable strain, tackling obesity stands head and shoulders above most. And the reason that you’re reading more about obesity is down to it being a health crisis that has long since reached boiling point, degrading the nation’s physical, mental, and social health year on year. The irony to this all is that the best interventions come at little financial cost – balanced nutrition, regular physical activity and reduced sedentary behaviour. However, the essential motivation and persistence is a price too high for many.

As such, rates of obesity in adults stand at 26 per cent for males and 27 per cent for females. This cumulatively places England as the sixth most obese country in the world – of which there are 195. Now, the impact on people with obesity will vary. Some may tick along without much need for the NHS (a very small proportion, mind you), while the rest risk developing obesity-related conditions such as osteoarthritis of the knees, gallstones, type 2 diabetes, cancer and cardiovascular disease. These are often coined as lifestyle diseases, the majority of which are preventable.

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All of this creates two streams of NHS obesity-related workload, which totaled 617,000 admissions in the last year: a 18 per cent rise from the previous year and a 334 per cent rise from 2009/10. The first stream, around 10,705 admissions, is directly treating obesity. For example, bariatric surgery – at cost to the NHS but with the forward view that it will offset longer term costs had obesity been left untreated. The larger second stream is managing the obesity-related conditions.

It’s these chronic conditions that bleed not only the health and quality of life out of an individual, but also bleed cash and capacity out of the NHS. And it’s perhaps poignant to point out that this year marks the 70th anniversary of when the NHS was built upon three founding principles: accessible to all, treatment based on clinical need and not ability to pay, and free at the point of care. It’s clear that obesity-related diseases are contributing to a seismic shift in our health landscape, away from acute, treatable infections and towards chronic disease management. These NHS principles are struggling to cope with this.

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That, however, is not the worst part of our obesity story. Approximately 20 per cent of 10-year-olds are obese. And sadly, obese children are likely to grow up to be obese adults. This means the pressure from obesity on NHS services will receive a generational drip-feed that is likely to accrue until the NHS truly blows its breeches.

So your role in all of this is pretty simple: if you suffer from obesity, chances are your GP would have – well, should have – mentioned this and offered support. If they haven’t, then ask them. Ultimately, achieving a healthy weight is the best way to avoid getting caught in the chronic, clinical cross hairs of obesity.

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